Organization Active NPI

Nicholas Bushey DMD PLLC

Doing business as East Texas Children's Dentistry

  • Pediatric Dentistry
  • Mount Pleasant, TX
National Provider Identifier
1104720416
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
NICHOLAS BUSHEY DMD PLLC
Doing business as
East Texas Children's Dentistry
Practice address
401 W 19TH St
Mount Pleasant, TX 75455-2331
Phone
(903) 577-9900
Fax
(903) 577-9901
NPI assigned
Oct 8, 2026
Last updated
Oct 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nicholas Todd Bushey, DMD
Title
Pediatric Dentist
Phone
(903) 577-9900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

401 W 19TH St
Mount Pleasant, TX 75455-2331

Mailing address

401 W 19TH St
Mount Pleasant, TX 75455-2331
Phone (903) 577-9900

Other names 1

  • East Texas Children's Dentistry Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1104720416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W 19TH ST",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754552331",
            "telephone_number": "903-577-9900",
            "fax_number": "903-577-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W 19TH ST",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754552331",
            "telephone_number": "903-577-9900",
            "fax_number": "903-577-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS BUSHEY DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "BUSHEY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "903-577-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Texas Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.